Vascular anatomical considerations and clinical decision making during insertion of the Avalon® Elite Dual Lumen single-site veno-venous ECMO cannula in children weighing less than 20 kg

William Cory Ellis; Michal Schafer; Cindy S Barrett; Katie Butler; Andrew Sprowell; Mark Twite; Shannon Buckvold; Pei-Ni Jone; Richard J Ing

doi:10.1177/0267659118815104

Vascular anatomical considerations and clinical decision making during insertion of the Avalon^® Elite Dual Lumen single-site veno-venous ECMO cannula in children weighing less than 20 kg

Perfusion. 2019 May;34(4):267-271. doi: 10.1177/0267659118815104. Epub 2018 Dec 11.

Authors

William Cory Ellis¹, Michal Schafer², Cindy S Barrett², Katie Butler¹, Andrew Sprowell³, Mark Twite⁴, Shannon Buckvold², Pei-Ni Jone², Richard J Ing⁴

Affiliations

¹ 1 Perfusion, Heart Institute, Children's Hospital Colorado, Anschutz Medical Campus, University of Colorado School of Medicine, Aurora, CO, USA.
² 2 Cardiology, Heart Institute, Children's Hospital Colorado, Anschutz Medical Campus, University of Colorado School of Medicine, Aurora, CO, USA.
³ 3 University of Colorado Medical School, Heart Institute, Children's Hospital Colorado, Anschutz Medical Campus, University of Colorado School of Medicine, Aurora, CO, USA.
⁴ 4 Anesthesiology, Heart Institute, Children's Hospital Colorado, Anschutz Medical Campus, University of Colorado School of Medicine, Aurora, CO, USA.

PMID: 30537888
DOI: 10.1177/0267659118815104

Abstract

The correct selection and placement of a single-site Avalon^® Elite Dual Lumen Cannula for veno-venous extracorporeal membrane oxygenation (ECMO) in children weighing less than 20 kg is dependent on both the mechanical characteristics of the catheter, including length and diameter, as well as the unique vascular anatomic considerations of the patient. This manuscript describes the development of a clinical strategy, over a four-year period from 2012-2016, for cannula selection to reduce the risk of migration and malposition in 20 critically ill children weighing less than 20 kg who presented for veno-venous ECMO.

Keywords: Avalon; VV ECMO; cannulation; hepatic vein; malposition.

MeSH terms

Body Weight
Cannula
Child
Child, Preschool
Clinical Decision-Making / methods*
Extracorporeal Membrane Oxygenation / methods*
Female
Humans
Infant
Infant, Newborn
Male
Respiratory Insufficiency / therapy*
Retrospective Studies